Understanding Achalasia : Causes, Symptoms, and Treatment Options

Achalasia occurs when the lower esophageal sphincter, the muscular valve responsible for allowing food to enter the stomach, becomes impaired and fails to relax properly during swallowing.

Understanding  Achalasia : Causes, Symptoms, and Treatment Options

what is Achalasia ?

Achalasia is a fascinating medical  condition characterized by an impairment in the esophagus, the tube that connects the throat to the stomach. Specifically, it affects the  lower esophageal sphincter (LES) and the muscles  of the esophagus.


Normally, when we swallow  food or drink, the LES relaxes, allowing the food to enter the stomach. In individuals  with achalasia, the LES fails to relax properly, causing difficulties in  the passage of food into the stomach.


This happens due to damage or  degeneration of the nerve cells in the esophagus, which control  the constriction and relaxation of the muscles. Consequently, the  muscles of the esophagus cannot push the food down  effectively, causing a range of symptoms.


Common symptoms of achalasia  include difficulty swallowing (dysphagia), regurgitation of  undigested food, chest pain, weight loss, and  heartburn. It can significantly affect one's  ability to enjoy meals and lead to  nutritional deficiencies if left unaddressed.


To diagnose this  condition, medical professionals  typically conduct tests such as an upper  endoscopy, esophageal manometry, and perhaps a  barium swallow study.


What is the cause of Achalasia ?

The cause of achalasia, a  matter of great curiosity indeed While the exact cause  remains elusive, it is believed to result from a combination of  factors. One prominent theory suggests  that it occurs due to an autoimmune  response, where the body's immune system mistakenly attacks the nerve  cells responsible for controlling the muscles in the  esophagus.


In addition, certain  genetic factors may predispose  individuals to develop achalasia. It has been  observed that the condition can sometimes run in  families, suggesting a genetic component.


Furthermore, there have been  associations between viral infections, such as herpes  simplex virus (HSV), and the development of achalasia. It is hypothesized  that these infections might trigger an immune response  that leads to nerve damage.


Although rare, other potential  causes of achalasia include neurological disorders like  Chagas disease, certain cancers, or prior surgical interventions  that might damage the nerves or muscles in the esophagus.


However, do keep in mind that  each individual's experience with achalasia may differ, and the  underlying cause can vary from person to person.


What are  the symptoms of Achalasia ?

The symptoms of Achalasia, let  us explore them together! In this intriguing condition, the impaired  function of the esophagus can give rise to a range of troublesome symptoms. Here are the common signs to be aware of :


1.      Difficulty Swallowing (Dysphagia) :  The primary symptom experienced  by individuals with achalasia is difficulty swallowing. It may feel as if the food is  getting stuck or not passing smoothly through the esophagus. This  can apply to both solid foods and liquids.


2.    Regurgitation :  Along with swallowing  difficulties, regurgitation of undigested food, sometimes hours  after a meal, is a common symptom. It may be  accompanied by a bitter or sour taste in the mouth.


3.    Chest Pain :  Many individuals with achalasia  experience chest pain or discomfort, which  can be mild to severe. It may be  present during or  after eating.


4.    Weight Loss :  Unintentional weight loss is  often observed in those with achalasia. This is due to a  combination of reduced food intake and difficulties with  proper digestion and absorption.


5.     Heartburn :  Some individuals may experience  heartburn or a burning sensation in the chest, similar to  gastroesophageal reflux disease (GERD). This can be a  result of the backflow of stomach acid due to the impaired function  of the lower esophageal sphincter.


My dear patient, please keep in mind that  the manifestation and severity of symptoms can vary  from person to person. It is crucial to consult with a healthcare  professional for an accurate diagnosis and appropriate treatment based on your unique presentation.


Together, we shall navigate  towards finding relief from these symptoms and restoring  harmony to your digestive system.


What is Achalasia disease diagnosis?

The diagnosis of Achalasia, a crucial  step towards understanding and addressing  this condition! Several diagnostic tests can aid in confirming the presence of  Achalasia and determining its subtype. Here are some common  methods used in the diagnostic process :


    Upper Endoscopy :  This procedure involves inserting a  flexible tube with a camera (endoscope) through the  mouth and into the esophagus. It allows the doctor to visually  examine the esophageal lining and rule out other potential  causes of symptoms.


    Esophageal Manometry  :  This test measures the muscle contractions and  coordination in the esophagus. It involves inserting a thin tube through the nose  and into the esophagus, which allows for the measurement of pressure changes as  you swallow. Esophageal manometry can help  identify the impaired muscle function  characteristic of Achalasia.


    Barium Swallow Study  :  During this test, you  will swallow  liquid containing barium, a contrast material visible on X-rays. X-ray images are then taken as  you swallow, allowing the doctor to observe the flow of the barium  through your esophagus. This test  can provide visual evidence of the narrowed  lower esophageal sphincter and the dilated esophagus  often seen in Achalasia.


Combining the information obtained from these diagnostic tests, along with a thorough assessment of your symptoms  and medical history, healthcare  professionals can make an accurate diagnosis of Achalasia and determine  the appropriate treatment plan  tailored to your needs.



What is Achalasia medical theory?

The medical theories surrounding  Achalasia, a topic that piques the interest of many! While  the precise cause of Achalasia remains somewhat elusive, several  theories exist to shed light on this intriguing  condition. Let me share a  few of these medical theories with you :


    Autoimmune Theory :  One prominent theory  suggests that achalasia may be  an autoimmune disorder. It proposes  that the body's immune system mistakenly  attacks the nerve cells in the esophagus, leading to  impaired function and muscle  abnormalities.


    Degeneration Theory :  Another theory proposes  that degeneration of the nerves in  the esophagus and the  lower esophageal  sphincter (LES) contributes  to Achalasia. This degeneration  could be due to aging or damage  from external factors.


    Hereditary Factors :  Genetic factors may also  play a role in the development of  Achalasia. Studies have  noted an increased incidence of achalasia  among relatives of affected individuals, indicating a potential  genetic predisposition.


    Viral Infection Theory :  Some studies have suggested  that viral infections, particularly from  herpes simplex virus (HSV), may trigger an inflammatory  response that leads to nerve  damage, contributing to the development of Achalasia.


It is important to note that  these theories are constantly  evolving as research progresses. Furthermore, it is likely that  multiple factors, including genetic and  environmental influences, contribute to the development  of Achalasia.


What is Achalasia  treatment?

The treatment options for  Achalasia, a topic of great importance for those seeking relief from its symptoms. Let  us explore the various approaches available :


1.      Medications :  Certain medications can  help relax the lower esophageal sphincter (LES)  and ease the passage of food through the esophagus. These may  include calcium channel blockers like nifedipine, or nitrates like  isosorbide dinitrate. However, it's important to note that medication  alone may not provide long-term relief.


2.    Pneumatic Dilation (Balloon Therapy) :  This procedure involves inserting a deflated  balloon into the esophagus and inflating it to stretch and  widen the narrowed lower  esophageal sphincter. This can help improve  food passage. It is an effective  treatment option, though additional  sessions may be required.


3.    Botox Injections :  In some cases, injecting  botulinum toxin (Botox) into the lower esophageal  sphincter helps relax the  muscle, allowing for better food flow. However, the  effects of Botox injections are temporary and  may require repeated treatments.


4.    Surgical Interventions :  Surgical options are considered for cases where other  treatments have been  ineffective or if desired as a primary choice. Two common  surgical procedures are Heller myotomy and laparoscopic  esophagomyotomy. These techniques involve cutting the muscle  fibers of the LES to relieve the blockage.


5.     Peroral Endoscopic Myotomy (POEM) :  A relatively newer minimally invasive  procedure, POEM, involves  accessing the esophagus through an  endoscope and creating a myotomy to improve esophageal function.  It has shown promising results in treating Achalasia.


Treatment choices  should be  made based on  individual factors, such as the severity  of symptoms, patient age, overall health, and personal  preferences. It is essential to consult with  a healthcare professional who can assess  your specific case and guide you towards the most  suitable treatment option.

What is Diet & Supportive Treatment?


The role of diet and supportive  treatments in the management of Achalasia, a topic of great  significance indeed. While these considerations may  not directly address the underlying cause of Achalasia, they can  greatly  contribute to symptom relief and improve overall well-being. Let  us explore them together :


 1.   Diet Modifications :  Making certain adjustments to  your diet can help ease the symptoms of  Achalasia. Here are some recommendations  to consider :

·        Eat smaller, more frequent  meals rather than large meals.

·        Chew your food thoroughly  and eat slowly to aid in digestion.

·        Avoid foods that are difficult  to swallow, such as tough meats or dry bread.

·        Opt for softer or pureed foods  that can be easily swallowed.

·        Drink plenty of fluids with meals  to help food move through the esophagus.

·        Avoid consuming large amounts  of liquids or extremely hot beverages, as they  may exacerbate symptoms.


 2.  Good Eating Habits :  In addition to dietary modifications,  adopting good eating habits can  significantly aid in managing Achalasia. This includes :

·        Sitting upright while eating to  allow gravity to assist in food passage.

·        Avoiding lying down immediately  after meals to prevent reflux.

·        Taking smaller bites and  sips to facilitate easier swallowing.

·        Avoiding eating close to  bedtime to minimize discomfort during sleep.


3.    Emotional Support :  The impact of Achalasia extends  beyond physical symptoms and can  affect one's emotional well-being. Seeking emotional support from  loved ones, support groups, or mental health professionals can  be beneficial in coping with the challenges associated  with this condition.


4.  Stress Reduction :  Stress can exacerbate  symptoms, so it is essential to employ stress reduction  techniques such as deep breathing exercises, meditation,  yoga, or engaging in activities that promote  relaxation.


Remember, my dear patient, that these  supportive measures should complement the primary  treatment plan recommended by your healthcare  professional. Each individual's dietary  needs and supportive  requirements may vary, so it is important  to consult with a healthcare  provider or a registered dietitian who  can provide personalized guidance.


Together, we shall strive to  integrate these dietary and  supportive strategies into your  lifestyle, fostering improved symptom management and  overall well-being in  your journey with Achalasia.


Learn from the video also

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Achalasia: A vagus nerve disorder and its connection to the neck - Ross Hauser, MD

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 Causes, symptoms, Diagnosis &Treatment of achalasia cardia | Dr. G. Parthasarathy | KIMS Hospitals


ACHALASIA FAQ (Frequently Asked Questions)


Is achalasia cancerous?

No, achalasia itself is not cancerous.


What drugs cause achalasia?

The specific cause of  achalasia in relation to  drugs is not well established.


Is achalasia life threatening?

Achalasia itself is not  typically life-threatening, but  complications may arise if  left untreated.


Can you live a normal life with achalasia?

With proper  management and  treatment, many  people with achalasia can  lead fulfilling lives.


Is hot water good for achalasia?

Hot water is not  specifically recommended for  achalasia, as extreme temperatures can  potentially aggravate symptoms.


How do you sleep with achalasia?

Sleeping with the head  slightly elevated using a wedge  pillow or by propping up the upper  body with additional  pillows can help alleviate nighttime reflux and  discomfort associated with achalasia.


Can CT scan detect achalasia?

While a CT scan can  provide information about esophageal abnormalities, it is not the  primary diagnostic tool for achalasia, as other tests like esophageal manometry and barium swallow are typically used  for diagnosis.


What age does achalasia start?

Achalasia can  occur at any age, but it is  commonly diagnosed between the  ages of 25 and 60.


Is achalasia genetic?

The exact cause  of achalasia is unknown, but there  is evidence suggesting  a potential genetic component,  although it is not considered a  clearly genetic disorder.


Does achalasia affect breathing?

Achalasia itself does  not directly affect breathing, but  in rare cases, severe symptoms or  complications may indirectly impact  breathing.


What vitamins help achalasia?

There is no  specific vitamin  known to directly help with  achalasia, but a balanced diet  rich in vitamins and minerals  can support overall health and  well-being.


Is there a permanent cure for achalasia?

While there is currently  no known permanent cure for  achalasia, treatments  such as endoscopic procedures, pneumatic  dilation, or surgical intervention  can effectively manage symptoms  and improve quality of life  for many patients.


Which drink is good for esophagus?

Drinking warm  herbal teas, such as chamomile  or slippery elm tea, can help soothe  the esophagus and provide  relief for certain esophageal  conditions.


Can achalasia be caused by COVID?

There is currently  no evidence to suggest that  achalasia is directly caused by  COVID-19 infection.


Can achalasia return?

Although  treatment can provide  symptom relief, achalasia can potentially recur or require  additional interventions in some cases.


Talk to your doctor or nurse if you have any questions or concerns.



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